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Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of right bronchial disruption caused by blunt chest trauma was successfully operated. Patient is a 35-year-old woman who was transferred to our intensive care unit with markedly dyspnea and subcutaneous emphysema. Rupture of right bronchus was suspected by chest x-ray film and bronchial fiberscopy. An emergency thoracotomy was performed with the aid of selective lung ventilation by the use of double lumen endobronchial tube. Right bronchus was completely transected and small part of upper lobe was lacerated. Right bronchus was anastomosed directly with interrupted 3-0 vinyl sutures and laceration of upper lobe was sutured. Postoperative course was uneventful, but postoperative bronchoscopy confirmed slight stenosis of the anastomotic position. Prompt diagnosis by bronchoscopy and emergency thoracotomy followed by selective lung ventilation are mandatory in this patient survival.
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PMID:[A case of complete disruption of right truncus intermedius treated by operation]. 259 2

Respiratory muscle function was assessed in six patients with the Lambert-Eaton myasthenic syndrome. Five had histologically proved small cell carcinoma of the lung; the sixth later developed metastases from an unknown primary site. Two patients had ventilatory failure, one without respiratory symptoms; another, who had emphysema, had dyspnoea and orthopnoea. The remaining three patients had no respiratory symptoms. Four patients had limb muscle weakness as judged by the maximal voluntary contraction of the quadriceps muscle (range for all subjects 32-100% predicted). Transdiaphragmatic pressure (Pdi) was measured during a maximal unoccluded sniff (Pdi: sniff), a maximal sustained inspiratory effort against a closed airway (Pdi: Pimax), and phrenic nerve stimulation (Pdi: twitch). Mild to moderate diaphragmatic weakness was present in all six patients in proportion to the degree of leg weakness (Pdi: sniff 30-64% predicted; r = 0.6; Pdi:Pimax 6-69% predicted, r = 0.8); this was associated with very low or absent Pdi:twitch during phrenic nerve stimulation. Four patients had weakness of the expiratory muscles. Improvement in muscle strength was documented in two patients after tumour chemotherapy and specific treatment with 3,4-diaminopyridine and prednisolone; one patient was still alive five years from first diagnosis. It is concluded that the respiratory muscles may be implicated in this condition more often than has previously been recognised. As the lack of mobility may cause respiratory symptoms to be minimised, the presence of respiratory muscle weakness may remain undiagnosed unless formal measurement of respiratory muscle function is made.
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PMID:Respiratory muscle weakness in the Lambert-Eaton myasthenic syndrome. 259 31

Five infants with congenital lobar emphysema whose main symptoms included dyspnea, cyanosis and recurrent respiratory infections, are presented herein. The most reliable diagnostic tool was plain chest X-ray films with antero-posterior and lateral views, while radio-isotopic investigation of the lung perfusion state took second place in the diagnosis of this disease. The affected lobes were the left upper lobe in four patients and the right middle lobe in one. Lobectomy was performed with good results in 4 patients, however, 1 infant was lost following an emergency thoracotomy.
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PMID:Congenital lobar emphysema--a report of 5 cases. 260

A 67-year-old woman was admitted to our hospital with chest pain and dyspnea which occurred suddenly after vomiting. She was well until admission except for cholelithiasis and hypertension which had been pointed out 3 years earlier. Arterial blood gas analysis showed hypoxemia without hypercapnea. Chest X-ray examination on admission revealed intra-mediastinal air with a niveau behind the heart which compressed the vasculature of the left lower lobe and a small amount of air in the regions adjacent to the trachea, left main bronchus and aortic arch. The serial chest radiographs showed pneumomediastinum, subcutaneous emphysema, pneumothorax and pleural effusion in that order within 16 hours after the onset. The diagnosis of esophageal rupture was made by CT scan of the chest performed after oral administration of Gastrografin, which demonstrated extravasation of contrast medium into the mediastinum. Surgical treatment including eversion stripping and esophagogastrostomy was performed 23 hours after the onset. Pathological examination of the removed specimens revealed a rupture of the lower portion of the esophagus originated in the gastric ulcer of the cardia. In spite of intensive care, she died 45 days after surgery because of renal failure. It was considered that the most important point in the early diagnosis of esophageal rupture was to suspect this disease based on the gastric symptoms followed by the respiratory symptoms and to demonstrate pneumomediastinum in chest X-ray. Chest CT scan performed after the oral administration of contrast medium could be an useful and non-invasive diagnostic procedure.
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PMID:[A case of esophageal rupture confirmed by chest CT: characteristic changes in chest radiographs]. 261 3

Three patients with chronic respiratory failure of various etiology, who have (had) been in the hospital for some years, were presented. The case 1 is male and was 57 years old on admission. He has been suffered from right thoracic emphysema from October '83, which is under chronic infection of Pseudomonas aeruginosa, with bronchial fistula and aortic valve insufficiency. His pulmonary function is severely restrictive and the grade of his dyspnea has been V of Hugh-Jone's criteria and he is now unable to leave from bed. The case 2 is male and was 41 y.o. on admission. He has been ill with diffuse cystic bronchiectasis from 33 y.o. and bronchorrhea (greater than 200 ml/day) with chronic infection of Pseudomonas aeruginosa has been lasting and recurrent attacks of infection have progressively worsened of his pulmonary and cardiac functions. He is now indispensable to assist ventilation by artificial respirator every 2-3 days. The case 3 was male and 27 y.o. on admission. He had admitted because of severe dyspnea due to familial pulmonary fibrosis on August '86. His disorder had been progressive and resistant against repeated corticosteroid therapy. He died of respiratory failure at 30 years old. The transplantations of lung and heart-lung for critical patients with respiratory failure have been challenged in North America and Europe, but in Japan, many social and medical problems about transplantation have yet been unresolved. The indications for and against lung or heart-lung transplantation to these three patients was discussed with reference to English literatures.
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PMID:[Three cases of chronic respiratory failure]. 262 Jan 34

Twenty-five patients with chronic bronchitis and emphysema were studied in an attempt to evaluate clinical methods for rating dyspnoea. Whereas the Medical Research Council (MRC) dyspnoea scale and the 12-minute walking test showed good correlation with pulmonary function tests, the visual analogue scale (VAS) did not. When the dyspnoea scales were compared with one another, the MRC scale and the VAS and the MRC scale and 12 minute walking test showed good correlation with one another.
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PMID:Correlation of lung function tests with dyspnoea scale, 12 minute walking test and visual analogue scale in patients with COPD. 263 64

Respiratory rehabilitation in patients with pulmonary emphysema should be focussed first on the prevention and elimination of harmful inhalative factors, e.g. smoking habits and environmental or occupational pollution. In addition, distinct therapeutical procedures are mostly effective in preventing a progressive course of the disease and interrupting the vicious circle of dyspnea, physical inactivity and overall disability as well. In patients with advanced disease, mostly complicated by features of chronic respiratory insufficiency and cor pulmonale, long-term administration of oxygen often relieves symptoms, increases physical performance and may even reduce hospital admissions for a longer period. As a consequence, most patients with severe disability also suffer from severe psychological and social problems which should be considered more attentively within the concept of the overall rehabilitation program.
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PMID:[Pulmonary rehabilitation in pulmonary emphysema]. 264 28

Lesions in 32 calves that died or were euthanatized during the course of severe natural infection with bovine respiratory syncytial virus (BRSV) are described. All calves had been dyspneic for 1 to 2 days. At necropsy, lesions that could be related to dyspnea included congested and cyanotic mucosae and widespread petechiae. The lungs had various lesions in the cranioventral (CV) and caudodorsal (CD) portions. The CV portion of the lungs was consolidated, firm, and edematous. Histologically, the main characteristic was degenerative, necrotic bronchiolitis, with few syncytial cells. Signs of repair, such as epithelial hyperplasia, fibrosis, and bronchiolitis obliterans, often were observed. The CD portion of the lungs was markedly distended, owing to severe edema and emphysema. Bronchiolar lesions were lacking in the CD portion. In 14 calves, hyaline membranes were seen in the CV and CD portions. Results of immunofluorescence for BRSV were positive in 24 calves, but only in the CV portion of the lungs. The calves had variable concentrations of BRSV-specific IgG1 and IgM in serum, lung lavage fluid, or both. The BRSV-specific IgA, on the contrary, was seldom detected. Thus, 2 discrepancies existed. Although the clinical picture appeared to be acute, bronchiolar lesions and serotest results suggested infection of longer duration. Also, although virus and viral cytopathologic features were detected only in the CV portion of the lungs, the CD portion had extensive lesions that consisted of emphysema and edema.
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PMID:Pathogenesis of naturally acquired bovine respiratory syncytial virus infection in calves: morphologic and serologic findings. 272 14

A review of 2,092 patients who had sustained closed thoracic trauma or undergone mechanical ventilation was made in order to clarify the incidence, clinical picture, pathogenesis and prognosis of pneumomediastinum without pneumothorax or lesion of mediastinal organs. Air in the mediastinal space was observed in ten patients (0.5% of cases). Bronchial and esophageal lesions were excluded at bronchoscopy and esophagoscopy. The clinical presentation included subcutaneous emphysema of the neck, without signs of mediastinitis. No patient had pain or dyspnoea. Trauma or barotrauma were assumed to have caused sudden rise in the intrapulmonary pressure, leading to passage of air from the parahilar alveoli into the mediastinum along the peribronchial and perivascular spaces. Management was conservative and the prognosis good, with normalization of the chest radiogram usually within a week.
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PMID:Pneumomediastinum not associated with lesion of mediastinal organs. 274 23

In view of the common findings that patients with pulmonary disease exhibit larger maximal exercise hyperpnea (Vmax) than their maximal voluntary ventilation (MVV), the limiting factor for the exercise loading in these patients has been considered to be excessive hyperventilation. Recently, plasma potassium released from exercising muscle has been found to effectively stimulate arterial chemoreceptors. This effect is further potentiated by the presence of hypoxia. Since patients often become hypoxemic by exercise loading, it was suspected that potassium may play a role to limit exercising capacity due to excessive stimulation of the peripheral chemoreceptors. In 1975, Kawakami et al. reported that in response to exercise loading emphysematous type patients exhibited higher potassium and lactic acid concentration than the bronchitic and mixed type COPD patients. Their findings, together with breathlessness often seen in the emphysema may be further evidence supporting the inference mentioned above.
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PMID:[On the role of potassium as a limiting factor for exercise hyperpnea]. 274 71


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